Depression in paroxysmal and persistent atrial fibrillation patients: a cross-sectional comparison of patients enroled in two large clinical trials†

Objective: To identify the risk factor profile of Atrial Fibrillation applying CHA2DS2-VASC scoring system Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted in outdoor patient and emergency departments of Armed Forces Institute of Cardiology/National Institute of Heart Diseases in 4 months duration after approval of synopsis, from Sep 2019 to Dec 2019. Methodology: All patients with symptoms of palpitation and dyspnea were evaluated with detailed history, physical examination, electrocardiogram and 2-D echocardiography for collection of data. Patients who were found with Atrial Fibrillation on electrocardiogram and non-valvular on 2-D echocardiography were enrolled. Detailed History regarding CHA2DS2-VASC scoring system was taken. Patients with age <18 years, those with moderate rheumatic stenos is, hypertrophic cardiomyopathy and Atrial Fibrillation with prosthetic valves were excluded. Data was entered and analyzed with SPSS-23. Results: Out of 100 patients enrolled, frequencies of male and female patients were 60 (60%) and 40 (40%) respectively. The age varied from 25 years to 89 years with a mean age of 64.27 ± 12 years. Maximum number of patients was between 65-74 years (31%). Hypertension (57%) was the most common risk factor after gender followed by age. Frequencies of other risk factors were congestive heart failure (33%), diabetes mellitus (18%), vascular disease (14%) and stroke/TIA/thrombo-embolism (13%). Paroxysmal atrial fibrillation was the most common type of atrial fibrillation observed (67%) followed by persistent atrial fibrillation (31%). The number of patients having CHA2DS2-VASC score 2 and greater than 2 were 76 (76%) and less than 2 were 24%. Conclusion: Our findings highlighted the prevalence of non-modifiable as well as modifiable predictors of thromboembolic phenomena in atrial fibrillation using CHA2DS2-VASC scoring system in our population.

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Aortic stiffness—Is kynurenic acid a novel marker? Cross-sectional study in patients with persistent atrial fibrillation

PLoS ONE ◽

10.1371/journal.pone.0236413 ◽

2020 ◽

Vol 15 (7) ◽

pp. e0236413

Author(s):

Tomasz Zapolski ◽

Anna Kamińska ◽

Tomasz Kocki ◽

Andrzej Wysokiński ◽

Ewa M. Urbanska

Keyword(s):

Atrial Fibrillation ◽

Aortic Stiffness ◽

Kynurenic Acid ◽

Persistent Atrial Fibrillation ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Efficacy of ganglionated plexi ablation in addition to pulmonary vein isolation for paroxysmal versus persistent atrial fibrillation: a meta-analysis of randomized controlled clinical trials

Journal of Interventional Cardiac Electrophysiology ◽

10.1007/s10840-017-0285-z ◽

2017 ◽

Vol 50 (3) ◽

pp. 253-260 ◽

Cited By ~ 10

Author(s):

Polydoros N. Kampaktsis ◽

Evangelos K. Oikonomou ◽

Daniel Y. Choi ◽

Jim W. Cheung

Keyword(s):

Atrial Fibrillation ◽

Clinical Trials ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Meta Analysis ◽

Persistent Atrial Fibrillation ◽

Controlled Clinical Trials ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled ◽

Ganglionated Plexi

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Radiofrequency ablation and antiarrhythmic therapy in the treatment of patients with paroxysmal and persistent atrial fibrillation: clinical effects

Cardiosomatics ◽

10.26442/cs45142 ◽

2015 ◽

Vol 6 (3) ◽

pp. 38-47

Author(s):

M. G Bubnova ◽

D. M Aronov ◽

M. M Makhinova

Keyword(s):

Atrial Fibrillation ◽

Clinical Trials ◽

Radiofrequency Ablation ◽

Randomized Clinical Trials ◽

Pulmonary Veins ◽

Persistent Atrial Fibrillation ◽

Antiarrhythmic Therapy ◽

Clinical Effects

The purpose of this article is to discuss the issues related to the treatment of patients with paroxysmal and persistent atrial fibrillation (AF). The article discusses the indications for patients with radiofrequency catheter (RFC) ablation of the mouths of the pulmonary veins and based on the results of randomized clinical trials analyzed the clinical effects of this procedure, depending on the type of AF. The article discusses the initiation of antiarrhythmic therapy and the duration of its application after RFC.

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Comparative efficacy and safety of different catheter ablation strategies for persistent atrial fibrillation: a network meta-analysis of randomized clinical trials

European Heart Journal - Quality of Care and Clinical Outcomes ◽

10.1093/ehjqcco/qcab066 ◽

2021 ◽

Author(s):

Andrea Saglietto ◽

Andrea Ballatore ◽

Fiorenzo Gaita ◽

Marco Scaglione ◽

Roberto De Ponti ◽

...

Keyword(s):

Atrial Fibrillation ◽

Clinical Trials ◽

Catheter Ablation ◽

Left Atrium ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Persistent Atrial Fibrillation ◽

Linear Lesions ◽

Procedural Complications ◽

Reduced Risk

Abstract Aims Whereas pulmonary vein isolation (PVI) is the universally agreed target in catheter ablation of paroxysmal atrial fibrillation (AF), an ideal ablation set in persistent AF remains questioned. Aim of this study is to conduct a network meta-analysis (NMA) of randomized clinical trials (RCTs) comparing different ablation strategies in persistent AF patients. Methods and results Network meta-analysis was performed in a frequentist framework with the different ablation strategies constituting the competitive arms of interest. Primary efficacy endpoint was recurrences of atrial tachyarrhythmia (AF, atrial flutter, and/or organized atrial tachycardia). Secondary endpoints included major peri-procedural complications, procedure, and fluoroscopy duration. PubMED/MEDLINE and EMBASE databases were searched through June 2020. 2548 records were screened and 57 full-text articles assessed. Eventually 24 RCTs were included, encompassing 3245 patients (median follow-up 15 months, IQR 12–18). Compared to PVI alone, PVI plus linear lesions in the left atrium and elimination of extra-PV sources was the only strategy associated with a reduced risk of arrhythmia recurrence (RR 0.49, 95%CI 0.27–0.88). Most treatment arms were associated with longer procedural time compared with PVI; however, major peri-procedural complications and fluoroscopy time did not differ. Conclusion A comprehensive strategy including PVI, linear lesions in the left atrium, and elimination of extra-PV sources (constrained by a heterogeneous definition across studies) was associated with reduced risk of recurrent atrial tachyarrhythmias compared to PVI alone. All investigated treatment arms yielded similar safety profiles. Further research should rely on enhanced substrate-based approach definitions to solve one of the most evident knowledge gaps in interventional electrophysiology.

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Clinical and echocardiographic predictors of silent cerebral infarctions in patients with persistent atrial fibrillation

Seminars in Cardiovascular Medicine ◽

10.2478/semcard-2014-0003 ◽

2014 ◽

Vol 20 (2) ◽

pp. 10-17

Author(s):

Oleg Sychov ◽

Artem Borodai ◽

Svetlana Fedkiv ◽

Elina Borodai ◽

Taisia Getman ◽

...

Keyword(s):

Atrial Fibrillation ◽

Multivariate Analysis ◽

Creatinine Clearance ◽

Independent Predictor ◽

Univariate Analysis ◽

Persistent Atrial Fibrillation ◽

Cross Sectional Study ◽

Neurological Dysfunction ◽

Cross Sectional ◽

History Of

Summary Aim. The aims of the study were to evaluate prevalence of silent cerebral infarctions (SCI) and determine their clinical and echocardiographic predictors in patients with atrial fibrillation (AF). Patients and methods. In prospective cross sectional study we examined 134 patients with non-valvular AF. Clinical examination, laboratory tests, transoesophageal, transthoracic echocardiography and multislice computed tomography of the brain were performed for all patients. According to current guidelines, SCI was defined as imaging (≥3 mm) or neuropathological evidence of central nervous system infarction, without a history of acute neurological dysfunction attributable to the lesion. Results. Silent cerebral infarctions were detected in 34.3% (n = 46) of patients, and infarctions ≥ 15 mm (mean diameter 31.3 mm) were detected in 11.2% (n = 15) of patients. Superficial SCIwere found in 12.7%and basal SCI in 21.6% of cases. In multivariate analysis low creatinine clearance < 90 ml/min was independently associated with small basal SCI (p = 0.04). In univariate analysis age ≥ 65 years was significantly associated with basal SCI, p = 0.004, but not with SCI ≥ 15 mm or superficial SCI. The results of multivariate analysis showed that CHA2DS2VASc score was an independent predictor of superficial SCI; low left atrial appendage velocity (LAAV) < 30 cm/s was independently associated both with SCI ≥ 15 mm (p = 0.03) and superficial SCI (p = 0.02). Conclusions. Large and superficial SCI were significantly and independently associated with low LAAV < 30 cm/s and other echocardiographic embolic risk factors and in case of absence of significant large arteries atherosclerosis may be considered as those of cardiac origin. Small basal SCI were associated with age and low creatinine clearance < 90 ml/min which was their independent predictor. CHA2DS2VASc score is useful for assessment of risk of cerebral infarctions even those without history of acute symptoms

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